Replies to post #52791 on Biotech Values

[rfj1862]

>A drug I’d cite as evidence of the toughness of selling to hospitals is Angiomax. It’s a fine drug, but it costs a lot more than heparin.<

Not a good example. Angiomax isn't competing against heparin. It is competing against the combination of heparin or LMWH and a glycoprotein IIb-IIIa inhibitor (primarily Integrilin and ReoPro).

[AlpineBV_Miller]

It’s a matter of degree, of course. Abraxane has a good enough label to pull it off

I'm certainly not trying to make a blanket statement disagreeing with you. In general, it's tough to compete in the managed care segment with a higher-priced product unless it is really better. The only caveat to that is the reimbursement status, which I think is more important than the label (presuming equivalence or better on the label). If the hospitals are reimbursed at a higher level, they'll go with the higher priced product. Maybe someone more familiar with the Abraxane reimbursement system can chime in and do a financial comparison between Abraxane and paclitaxel.

As far as Abraxane's label is concerned, they may well have got lucky. The control arm in the Sonus trial reinforces how unusually low the response rate was in the Abraxane pivotal. It's still a bit of a mystery (to me) why the FDA never blinked. The BCa docs we talked with were pretty uncomfortable. Abraxis (or whatever the hell their name is these days) has done a good job addressing that issue.